5 Steps to Get Americans on Board With Health Reform

The latest AP poll repeated the same trends in public healthcare reform sentiment. We are generally for it, until pollsters start presenting aspects as trade-offs. Once they hit one that resonates with one of us, we will promptly be against reform. We really can’t help it. As Change.org members regularly point out, we’re not a country that values solidarity, social worth or even basic human rights when they interfere with profits and self-interest. The United States is the nation of Me, not of Us. So, given we are unlikely to change our basic fabric any time soon, how do we get the public on board with meaningful healthcare reform?

I have the solution, and all it takes is 5 simple steps in public education. Before any of our brethren is allowed to answer another popular opinion poll regarding healthcare reform, they will be required to dig up one simple piece of information and digest 4 more. Follow these steps, and I predict a 99% "for healthcare reform" rating in the next poll.

1. Know Your Full COBRA Premium: For those insured through an employer, call up Human Resources and ask what the full monthly healthcare premium is (your employer’s and your contribution, combined.) Now, add 2%. That is your monthly COBRA premium, should you be separated from your employer. Will you pay that or the mortgage?
2. Know Pre-Existing Conditions That Insurers Deny: So, you think buying an individual policy is a better deal? You’d better be sure you don’t have one of the umpteen conditions that insurers will use to deny you benefits, before or after you buy coverage. There’s a basic starter list here, courtesy of the California Department of Insurance. But don’t forget the combinations of conditions that will also bar you from the Wild West of the individual health insurance market. For instance, say you have had back pain (80% of Americans) and also have diabetes, asthma, high blood pressure, or take prescriptions for just about anything. Sorry, you are the weakest link. Goodbye.
3. Know How Poor You Must Be To Receive Free or Indigent Care: Many people stand by the myth of free care at community hospitals, or use their belief in the Medicaid safety net as comfort. Guess what? Many community hospitals are NOT required to provide care regardless of your ability to pay, aside from EMTALA regulations that provide for care only in life/death or labor situations. Can’t pay? Try Medicaid (eligibility info at this link.) Do you make one dollar above the poverty level, or perhaps own a home or have a little savings stashed? Sorry, you don’t qualify. Oh, and by the way: you are now responsible for the entire bill, not just the pennies on the dollar that Medicaid is allowed to pay. So get extremely familiar with those poverty guidelines and make sure you stay within them. Or if you have a disease, just don’t get it treated.
4. Know The Cost of Cash Care: Now that you’ve seen your coverage options disappear, it’s time to get familiar with the cash prices you will be paying. It’s also helpful to see what a typical private insurer and Medicare would pay for the same services and prescriptions. Comparing costs to those in other countries might be helpful too. Ready? Take a look at average cash costs for an ER visit, an MRI, a routine hospitalization, a week in the ICU, breast cancer treatment, and heart attack and ongoing heart disease treatment (sorry, I don't have a list handy.) Oh, you didn’t know you’d be paying over 44 times more than Medicare and private insurers? Cash discounts don’t cut it in US healthcare. Those Medicare rates are looking mighty efficient compared to private plans too.
5. Know Medical Error Statistics and Local Quality of Care: Now that you’re feeling a little squeamish about the princely cost of care here in the Land of the Free, and how easily you can become a bankrupt cash cow, it’s time to get familiar with what you’re paying for. As the Institute of Medicine’s 1999 report, To Err Is Human, revealed, 44,000-98,000 preventable patient deaths occur each year due to medical errors, at a cost of $17-$29 billion. Much activity has taken place since then, but the 4 main drivers (fragmented care, licensing inattention to it, malpractice climate, few purchaser-based incentives) remain. Quality of care varies dramatically among hospitals and physicians alike, and even more so among different regions of the country. Generally it’s not nearly what it could be (and if you're uninsured, you're nearly twice as likely to die in the hospital as someone who has insurance anyway.) So check before you need to be seen, because #4 applies regardless of whether you receive safe, quality care.

So, now that you know how tenuous your grasp is on affordable access to quality care, you’re ready for the next poll. It’s not about “their” welfare (unless you’re among the wealthiest 1% who can afford healthcare regardless of the cost), it’s about yours. How do you feel about wholesale US healthcare reform?

A bonus Billionaires For Wealthcare song for you:
 

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